Latest California Healthline Stories
State Pilot Prompts Children’s Hospital To Form ACO
The California Department of Health Care Services has chosen Rady Children’s Hospital in San Diego to manage the care of medically vulnerable children via a newly formed accountable care organization, hoping for better care coordination and cost savings.
Disability Case Takes Unusual Turn
A federal judge temporarily halted automatic “trigger cuts” to the state’s budget that would reduce In-Home Supportive Services by 20%. A hearing on the issue, originally scheduled this month, is now scheduled Jan. 19.
In the meantime, a state declaration filed in the case said 66,000 Californians would be exempt from the cuts — including all children younger than age 21.
“In total, approximately 66,000 IHSS recipients will be completely exempt from the 20% reduction, which is roughly 15% of all IHSS recipients,” according to a declaration by Eileen Carroll, deputy director of the Adult Programs Division at the Department of Social Services.
Five Health Care Issues To Watch in 2012
Mark your calendars: A slew of ACA-related payment reforms, health IT changes and health insurance exchange updates will debut next year — even as constitutional questions over the law come to an end. (Maybe.)
Disabilities Case Waits on Supreme Court Ruling
A federal judge last week issued a stay of a court case challenging the freezing of some provider reimbursement rates for services for the developmentally disabled in California — effectively putting off the case until February or March, after the U.S. Supreme Court issues a ruling in a similar case it is currently hearing.
U.S. District Judge Morrison England Jr. denied the state’s request to dismiss the case. He also denied the plaintiffs’ request for a preliminary injunction on the rate freeze.
He cited a pending CMS ruling on health care provider costs that could also inform the court case. But the big one to wait for is the Supreme Court case, Douglas v. Independent Living Center, according to Tony Anderson of the Arc of California, which brought the case for the developmentally disabled.
Mental Health Services Heading to DHCS
Integration of care is one of the touchstones of the health care reform conversation. It’s a big and complicated task, though, to integrate health care for the 7.5 million Californians on Medi-Cal.
The state is taking a big step toward that goal by shifting Medi-Cal mental health benefits away from the Department of Mental Health and into the Department of Health Care Services by July 1 of next year. The idea is to incorporate mental health care and substance abuse treatment into people’s overall health care, so that it’s not a segmented benefit.
The tricky part is the transition, because you don’t want a disruption in care while you’re changing that organizational structure, according to Toby Douglas, director of DHCS.
How Can California Make Most of Telehealth Law?
With a new law in the books this fall — the California Telehealth Advancement Act — California is poised to move audio-visual technology into the medical mainstream. We asked experts what California policymakers and health care providers can do to make the transition proceed smoothly and effectively.
PCIP Enrollment Numbers Rise a Bit
The federally funded, state-run Pre-Existing Condition Insurance Plan has always been a bit of a tough sell.
It costs money, for one thing (premiums vary according to age and geography). And eligibility can be challenging: you have to have a pre-existing condition and be uninsured for six months.
That last requirement may be the toughest hurdle because those people with pre-existing conditions that are severe enough to be denied private insurance would have a hard time going uninsured for half a year.
Advocates, Business Groups Raising Concerns About State’s New Autism Coverage Mandate
Nicole Evans of the California Association of Health Plans, Henry Loubet of the insurance brokerage firm Keenan and Lorri Unumb of Autism Speaks spoke with California Healthline about the benefits and shortcomings of a new state law requiring private insurers to cover certain autism therapies.
PCIP Program Gets Last-Minute Funding
Last month, it looked like the federally funded, state-run Pre-Existing Condition Insurance Plan was about to reach its beneficiary limit. The Managed Risk Medical Insurance Board, which oversees the program, was considering closing enrollment.
At yesterday’s board meeting, officials said 813 new enrollees had been added to the system in the past month — leaving fewer than 800 slots still open. But MRMIB had good news up its sleeve.
“We received the 2012 amendment for the PCIP contract from the feds,” MRMIB Executive Director Janette Casillas said, “and they have given us an increase.”
‘Freeing’ Data May Be Tricky in California
The “Free the Data” movement, a national effort to encourage innovation in health care, has sparked a similar campaign to make California health data more easily available. But state laws and regulations may require some extra effort in the Golden State, experts say.